Tens of thousands of refugees and migrants continue to languish in camps and informal settlements across Europe, waiting for word on what their next move will be. The uncertainty these predicaments create are placing even more weight atop already fragile mental states, those working with them on the ground say.
“Nearly 75,000 refugees and migrants, including an estimated 24,600 children, currently stranded in Greece, Bulgaria, Hungary and the Western Balkans are at risk of psychosocial distress caused by living in a protracted state of limbo,” UNICEF warned Thursday in a press release.
It’s impossible for most refugees to know what the next step of their journey will entail ― and that causes serious stress. Depression and anxiety are commonplace.
“They don’t know if they’re staying in a [refugee] camp for two weeks or two years,” said Andres Barkil-Oteo, a psychiatrist with Doctors Without Borders (also known as MSF). “This prevents people from actually adjusting and accommodating to their new environment.”
Luckily, a little bit of psychosocial support goes a long way. Basic mental health interventions have led to significant improvements among people stuck in places like Greece, experts said.
Refugees and migrants can only access Europe via two primary points of entry ― from Turkey to Greece via the Aegean Sea, or from Libya to southern Italy via the central Mediterranean.
Many European countries have sealed off their borders to stem the influx of people. It means that people end up stuck in places like Greece and Serbia for indefinite periods of time, even though most hoped to head west toward countries with favorable asylum policies, like Germany and Sweden.
Greece has been hit especially hard since it’s a first point of entry. There are currently about 47,000 refugees and migrants in Greece, according to statistics from the U.N. refugee agency.
Organizations like UNICEF and MSF have been on the ground in these countries for many months. Psychosocial support is a core tenet of their work with refugee and migrant populations.
UNICEF said emotional distress is particularly acute among single mothers and children, who are often are awaiting to reunite with family members in other EU countries.
“Many single mothers are feeling stuck and seem to have lost motivation,” said Sofia Tzelepi, a lawyer working with UNICEF partner Solidarity Now. “Their emotional state affects their children.”
UNICEF provides basic psychosocial support to children across Greece’s mainland in the form of safe spaces, education and recreation.
“We know that for the majority this is going to be sufficient to recover and carry on,” said Laurent Chapuis, UNICEF’s Greece coordinator for the refugee and migrant response. “But this is also the way for us to identify the kids that are going to require extra help.”
Fortunately, only about 15 to 20 percent of the children they work with end up needing individualized psychological treatment, he added.
MSF offers three tiers of mental health support, Barkil-Oteo said. For those who need help coping with stress, psycho-educational campaigns have been created to inform people about their symptoms and about the arduous asylum process they are in the thick of.
Barkil-Oteo also helped lead more specialized group intervention exercises during his six months in Greece, he explained. They would discuss topics like stress or domestic violence.
“A lot of people don’t feel comfortable coming to us to do an individual session but require some type of support,” he said about the rationale behind group sessions. “You foster a place where people can help each other.”
MSF also provides traditional mental health services, including individual sessions with psychologists and medical consultations with psychiatrists like Barkil-Oteo.
But echoing Chapuis, he said these cases are the exceptions. Only about 20 to 25 percent of people required this kind of targeted intervention, he noted. Most are able to bounce back naturally with proper psychosocial support.
“People tend to be generally resilient and dynamic,” he said. “Many of them are actually doing really well and are even trying to help others.”